A dissertation submitted to the Graduate School in partial fulfilment for the Award of Master of Nursing (Midwifery and Women’s Health) Degree of Makerere University

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Background: Sexuality is one of the key components to be addressed during postnatal period for; it has long been a subject of secrecy and taboo in Africa. Resumption of sexual intercourse after giving birth has been shown to allow the men to “stay more at home” (do not have extramarital affairs) which reduces the risk of sexually transmitted infections like HIV/AIDS infections. The consequences of early resumption of sexual intercourse on the other hand, include unwanted pregnancy.
Objective: To determine the time at which women resume sexual intercourse after child birth, the factors associated with the timing and explore experiences of women attending postnatal and immunization clinics.
Methodology: The study employed both quantitative and qualitative research methods with a cross-sectional study design that enrolled 374 eligible women who delivered within the 6 weeks to 6 months prior to conducting the study. Quantitative data was gathered using a semi-structured questionnaire with both closed and open-ended questions. Qualitative data was gathered with the help of 3 focus group discussions (FGDs). Eligible women were recruited consecutively every day while purposive sampling was used to select eligible participants for FGDs. Data were analyzed using SPSS version 16.0. Univariate, bivariate, and multivariate analysis was conducted.
Results: The findings revealed that 21.6 percent of women had resumed sexual intercourse before 6 weeks after childbirth while 78.4% resumed between 6 weeks to 24 weeks. Mother’s occupation (P = 0.000), parity (P = 0.000), education level of the spouse (P = 0.000), age of baby (P = 0.025) and use of family planning (P = 0.000) were the factors that mostly influenced resumption of sexual intercourse after child birth. The key themes of the women’s experiences were ‘duration’, ‘libido’ ‘age’, ‘mode of delivery’, ‘family planning’ ‘privacy’, and health education. However, libido, mode of delivery, privacy and family planning were found to be associated with the timing of sexual intercourse.
Conclusion: The study concluded that ~ 22% of postpartum women resume sex before end of six weeks and majority of postnatal women did not receive health education on the timing of sexual resumption. Women with high income, low parity, spouses with high education level, mothers with younger babies, and the use of family planning were the main determinants of resumption of sexual intercourse.
Recommendations: Health workers and particularly midwives should educate clients on when sexual intercourse should be resumed after childbirth. In conducting such education, their male partners should be involved. Educational messages through health education talks, brochures and radios should be given.